1627 RUCKER AVE 2017-07-28 - Laserfiche WebLink

PERMIT APPLICATIO1I BUILDING=SECHANICAL / PLUMBING / SIGNFr==3RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES OL3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROCT SITE ADDRESS: PROPERTY TAX#: c%R— AUC LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CIN STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ?(1(ZTMEZ CONTRACTOR ADDRESS: STREET (S 3T /\/ V/ Y ?T" ST CITY SCA-(T-pc- STATE L,3(4 ZIP I �� CONTRACTOR PHONE: 2-0(o 222 7S (j CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): }}D �RPS 5 L^ L3 T- I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): j 7 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR C OTHER(Please Specify) CONTACT NAME: / CONTACT PHONE: 2 CONTACT EMAIL:pc,,2E-6017 C f-Zue c'c�ejc4-S7 ^^ � BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: I Heat Source: ❑Gas []Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: El New ❑Addition ❑Remodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler r Lavatory(Wash Basin) Drinking Fountain Water Heater I Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 10/12/2015)